Gonio Lens System With Stabilization Mechanism

ABSTRACT

This disclosure relates generally to methods and devices for use in viewing and positioning an eye with a gonio lens system, such as during ocular exams and ocular surgeries. Some embodiments of the gonio lens system can include a gonio lens for viewing one or more tissues and structures of the eye. In addition, the gonio lens system can include one or more positioning features for controlling movement positioning of the eye.

REFERENCE TO PRIORITY DOCUMENT

This application is a continuation of U.S. patent application Ser. No.14/507,123, entitled “Gonio Lens System with Stabilization Mechanism”filed Oct. 6, 2014, issuing as U.S. Pat. No. 9,226,658 on Jan. 5, 2016,which in turn claims priority to U.S. patent application Ser. No.13/656,326, titled “Gonio Lens System With Stabilization Mechanism,”filed Oct. 19, 2012, now U.S. Pat. No. 8,851,676, which in turn claimspriority of U.S. Provisional Patent Application Ser. No. 61/550,337,entitled “Gonio Lens System with Stabilization Mechanism,” filed Oct.21, 2011, and U.S. Provisional Patent Application Ser. No. 61/635,686,entitled “Gonio Lens System with Stabilization Mechanism,” filed Apr.19, 2012. Priority of the filing date of Oct. 21, 2011 is herebyclaimed, and the disclosures of the aforementioned patent applicationsare hereby incorporated by reference each in its entirety.

BACKGROUND

This disclosure relates generally to methods and devices associated witha gonio lens system which includes a viewing lens and one or morefeatures for controlling movement of the eye, such as during ocularsurgeries.

Many ophthalmic surgical procedures utilize a gonio lens forvisualization of the iridocorneal angle (“the angle”) of the eye. Thegonio lens can allow clinicians to visualize tissues comprising theangle of the eye which can be otherwise obstructed by the sclera.Visualization of the angle can be optimal when the clinician has controlover the positioning and movement of the eye globe during surgery, whichcan be an issue due to one of many different types of anesthetics usedto reduce pain (e.g., retro/peribulbar anesthesia, topical anesthesia,general anesthesia, etc.).

Movement of the eye globe during surgery (whether voluntary orinvoluntary) is a constant concern for the accuracy of implantation of adevice, placement of surgical instruments, and for patient safety.Placement of ophthalmic implants in the eye, including the angle of theeye, can be critical to implant performance. At least some ophthalmicsurgical procedures utilize either visualization or fixation techniquesin order to allow for more precise handling and placement of implants.However, some visualization and fixation techniques can be cumbersomeand apply an excessive amount of pressure on the eye which cancomplicate the procedure and damage the eye.

For example, added pressure on the eye can damage incisions in the eye,such as incisions formed during an ocular procedure. In addition, addedpressure on the eye can cause deformation of the eye globe which canmake the angle of the eye more difficult for a clinician to see.Particularly during ocular surgeries, such as implantation of an ocularimplant in the angle of the eye, difficulties in viewing important eyetissue and structures can result in complications and extended proceduretime.

In view of the foregoing, there is a need for an improved gonio lenssystem incorporating one or more features which can allow clinicians tovisualize and have positioning control of the eye without theapplication of excessive pressure on the eye.

SUMMARY

Some embodiments disclosed herein include a gonio lens system includinga handle, a gonio lens and a stabilization mechanism. The stabilizationmechanism can be configured to couple the gonio lens to the handle. Inaddition, the stabilization mechanism can be further configured to allowthe gonio lens to move relative to the handle.

Additionally, some embodiments disclosed herein include a gonio lenssystem comprising a handle, a gonio lens and an inner yoke. The inneryoke can be configured to couple the gonio lens to the handle. Inaddition, the inner yoke can be configured to permit the gonio lens tomove relative to the handle.

Some methods of use of the gonio lens system disclosed herein caninclude using a gonio lens system for viewing a part of an eye. Themethod can include applying an ocular lubricant on a surface of the eyeand placing a gonio lens of the gonio lens system in contact with thesurface of the eye. In addition, the method can include engaging one ormore positioning features which can be mechanically coupled to a handleof the gonio lens system with a part of the eye and moving the handle ofthe gonio lens system in order to at least one of stabilize the goniolens system, move the eye, or change a viewing angle of the gonio lens.Additionally, the method can include viewing a part of the eye throughthe gonio lens.

Some methods of use of the gonio lens system disclosed herein caninclude using a gonio lens system for fixing an eye in a position duringimplantation of an ocular implant. The method can include applying anocular lubricant on a surface of an eye and placing a gonio lens of thegonio lens system in contact with the surface of the eye. In addition,the method can include engaging one or more positioning features whichare mechanically coupled to a handle of the gonio lens system with apart of the eye and moving the handle of the gonio lens system in orderto position the eye in a position. Additionally, the method can includefixing the position of the eye with the handle and implanting an ocularimplant in the eye.

Other features and advantages should be apparent from the followingdescription of various embodiments, which illustrate, by way of example,the principles of the invention.

BRIEF DESCRIPTION OF THE DRAWINGS

These and other aspects will now be described in detail with referenceto the following drawings.

FIG. 1 shows a cross-sectional view of a portion of the human eye.

FIG. 2 is a cross-sectional view of a portion of the human eye showingthe iridocorneal angle of the eye and surrounding tissue structures.

FIG. 3 shows a first embodiment of a gonio lens system having anelongated handle attached to a distal head region.

FIG. 4 shows a side perspective view of the distal head region of thegonio lens system of FIG. 3.

FIG. 5 shows a bottom perspective view of the distal head region of thegonio lens system of FIG. 3.

FIG. 6 shows a top perspective view of the distal head region of thegonio lens system of FIG. 3.

FIG. 7 illustrates another embodiment of a gonio lens system.

FIG. 8 shows a side perspective view of a distal head region of thegonio lens system of FIG. 7.

FIG. 9 shows a bottom perspective view of a distal head region of thegonio lens system of FIG. 7.

FIG. 10 illustrates another embodiment of a gonio lens system includinga scleral depressor feature.

FIG. 11 illustrates another embodiment of a gonio lens system includinga pair of cleat arcs.

Like reference symbols in the various drawings indicate like elements.

DETAILED DESCRIPTION

The disclosed gonio lens system incorporates both visualization and eyepositioning features which can provide several advantages over currentsystems. Components of the disclosed system can be configured such thatvarious movements of the visualization and eye positioning features arestreamlined in order to achieve a more effective procedure. In addition,the streamlined movements of the visualization and positioning featurescan assist in minimizing pressure applied to the eye which can allow forimproved visualization and protection of the eye.

FIG. 1 shows a cross-sectional view of a portion of the human eye whichis generally spherical and covered on the outside by the sclera S. Theretina (not shown) lines the inside posterior half of the eye. Theretina registers the light and sends signals to the brain via the opticnerve. The bulk of the eye is filled and supported by a vitreous body,which is a clear, jelly-like substance. The elastic lens L is locatednear the front of the eye. The lens L provides adjustment of focus andis suspended within a capsular bag from the ciliary body CB whichcontains the muscles that change the focal length of the lens L.

A volume in front of the lens L is divided into two by the iris I, whichcontrols the aperture of the lens L and the amount of light striking theretina. The pupil is a hole in the center of the iris I through whichlight passes. The volume between the iris I and the lens L is theposterior chamber PC. The volume between the iris I and the cornea C isthe anterior chamber AC. Both chambers are filled with a clear liquidknown as aqueous humor. The ciliary body CB can continuously formaqueous humor in the posterior chamber PC by secretion from the bloodvessels. The aqueous humor can flow around the lens L and iris I intothe anterior chamber AC and exit the eye through the trabecular meshworkTM.

FIG. 2 is a cross-sectional view of a portion of the human eye showingthe iridocorneal angle (“the angle”) IA of the eye and surroundingtissue structures. A view of the angle IA can provide a variety ofinformation to a clinician viewing the angle IA, including the healthand condition of the eye. The angle IA is positioned between the iris Iand the cornea C and plays an important role in the circulation ofaqueous fluid in the eye.

The trabecular meshwork TM is an area of tissue in the eye locatedaround the base of the cornea C, near the ciliary body CB, and isresponsible for draining the aqueous humor from the eye via the anteriorchamber AC. The trabecular meshwork TM is spongy and can allow fluid todrain into the Schlemm's canal SC. The Schlemm's canal SC, also known ascanal of Schlemm or the scleral venous sinus, is a circular channel inthe eye that collects aqueous humor from the anterior chamber AC anddelivers it into the bloodstream via the anterior ciliary veins. TheSchlemm's canal SC is essentially an endothelium-lined tube, resemblingthat of a lymphatic vessel. The inside of Schlemm's canal SC, nearest tothe aqueous humor, is covered by the trabecular meshwork TM. This regioncan make the greatest contribution to outflow resistance of the aqueoushumor.

The width of the iridocorneal angle IA is one factor affecting thedrainage of aqueous humor from the eye's anterior chamber AC. A wide oropen angle allows sufficient drainage of aqueous humor through thetrabecular meshwork TM (unless obstructed), whereas a narrow angle canimpede the drainage system and leave the patient susceptible to acuteangle-closure glaucoma. Gonioscopy can indicate the angular width of theiridocorneal angle IA, such as by enabling a clinician to identify thenumber of ocular structures visible above the rim of the iris I.Generally the more structures visible, the wider the angle IA.

The disclosed gonio lens system can incorporate a gonio lens which canbe used for angle visualization and one or more positioning features forcontrol of the globe of the eye. The gonio lens system can be used invarious procedures involving the eye, including ocular surgeries. Thegonio lens and positioning features can be mounted onto a handle, eachwith their own stabilization mechanism. In addition, the gonio lenssystem can incorporate independent yet synergistic pivot and rotationpoints for the gonio lens and positioning features which can allow eachto move with one or more degrees of freedom.

The gonio lens system can be used without exerting excessive pressure onthe eye, such as on the anterior chamber. Added pressure on the eyeduring an ocular procedure can cause deformation of the eye globe whichcan make, for example, the angle of the eye more difficult for aclinician to see. Particularly during ocular surgeries, such asimplantation of an ocular implant in the angle of the eye, difficultiesin viewing important eye tissue and structures can result incomplications and extended procedure time.

Visualization features of the gonio lens system can include a gonio lenswhich can be effective for viewing the angle of the eye. In addition,one or more stabilization features of the gonio lens system can assistin stabilizing the gonio lens on the eye. Additionally, some featurescan allow the gonio lens to move, such as slide along the cornea of theeye, independent of handle movement. Both stabilization and controlledmovement of the gonio lens can be important features of the gonio lenssystem. For example, the ability of the clinician to move the gonio lenscan allow a clinician to view a variety of tissues and structures of theeye, including the angle of the eye. By way of further example, theability of the clinician to stabilize the gonio lens can assist inviewing the angle of the eye during implantation of an ocular implant.The stabilization and controlled movement of the gonio lens can assistin reducing procedure time and improve cost savings.

The one or more positioning features can provide both stabilization(e.g., fixing the eye in a specific position) and controlled movement(e.g., rotating) of the eye which can provide several advantages. Byallowing the clinician to stabilize or fix the position of the eye globewith positioning features the clinician can efficiently and effectivelyview the eye and perform intricate ocular procedures, such asimplantation of an ocular implant. In addition, positioning features canbe used by the clinician to move the eye globe instead of changingviewing angles of microscopes during surgery which can be more timeconsuming. The ability of the positioning features to providestabilization and controlled movement can also assist in reducingprocedure costs and complications.

FIG. 3 shows a first embodiment of a gonio lens system 105 having anelongated handle 110 attached to a distal head region 112. The distalhead region 112 can include a gonio lens 115 movably mounted to astabilization mechanism 120. The stabilization mechanism 120 can beconfigured to be stabilized relative to a patient's eye while permittingmovement of the gonio lens 115 relative to the handle 110. The goniolens system 105 can be configured to be positioned adjacent a patient'seye using the handle 110 which can be grasped by a user, such as aclinician.

FIGS. 4-6 illustrate enlarged views of the distal head region 112 of thegonio lens system 105. As mentioned, the distal head region 112 caninclude a gonio lens 115 which can be movably mounted to a stabilizationmechanism 120. The stabilization mechanism 120 can further assist instabilizing one or more positioning features. As shown in FIGS. 4-6, thestabilization mechanism 120 can include a bracket 205 extending from adistal end of the handle 110 having extensions which can pivotally mounta stabilizing bracket 210. A bottom surface of the stabilizing bracket210 can have one or more protrusions 215 which can be configured tointeract with the eye, such as move and position the eye globe.

The protrusions 215 can be configured to be placed against the eye(e.g., sclera, conjunctiva) and can have a rounded shape in order toprevent damage to the eye during contact. The protrusions 215 can alsoinclude features, including surface features, which can assist theprotrusions 215 in controlling the movement of the eye, such as eithermove or hold the eye in a position. In addition, any number ofprotrusions 215 having a variety of shapes and sizes can extend from thestabilizing bracket 210 for at least assisting with moving andpositioning the eye.

The stabilizing bracket 210 can be pivotally mounted to the bracket 205which can allow relative rotational movement between the bracket 205 andstabilizing bracket 210. A pair of pins 211 can assist in pivotallymounting the stabilizing bracket 210 to the bracket 205. The bracket 205and stabilizing bracket 210 can be U-shaped, as shown in FIGS. 4-6,which can assist in allowing the bracket 205 and stabilizing bracket 210to form a compact assembly and move relative to each other. Although thebracket 205 and stabilizing bracket 210 are shown as both beingU-shaped, either the bracket 205 or stabilizing bracket 210 can be sizedand shaped in a variety of sizes and shapes, as well as having similaror different shapes.

FIG. 4 shows an embodiment of a lens bracket 225 attached to a lens belt233 with the lens belt 233 secured to the gonio lens 115. The lens belt233 can be secured around at least a part of the gonio lens 115 and caninclude a pair of extruding pins 232. The pair of extruding pins 232 canslideably couple to a pair of slots 230 extending along a part of thelens bracket 225. The pair of slots 230 can allow the pair of extrudingpins 232 to travel along the length of the slots 230, which can allowmovement of the gonio lens 115 relative to at least the lens bracket225. In this configuration, for example, the gonio lens 115 can slidealong the cornea without moving the handle 110.

FIGS. 5 and 6 illustrate the lens bracket 225 which can be pivotallymounted to a support 226 of the stabilization bracket 210. The lensbracket 225 can be U-shaped, as shown in FIG. 6, or the lens bracket 225can be any of a variety of shapes and sizes. In addition, the lensbracket 225 can include a tab 405 which can mate with or abut a biasingmember 410. In this configuration, the biasing member 410 can limit therotational movement of the lens bracket 225 and assist in biasing thelens bracket 225 and gonio lens 115 toward the user's eye when the goniolens system 105 is in use. The biasing member 410 can be secured to apart of the stabilizing bracket 210 or any part of the stabilizationmechanism 120 which can allow the biasing member 410 to assist inappropriately biasing the lens bracket 225.

The configuration of the various components of the stabilizationmechanism 120, such as the stabilizing bracket 210, bracket 205 and lensbracket 225, can provide several degrees of freedom of movement of thegonio lens 115 relative to the handle 110. The degrees of movement caninclude rotational and translational movement, and the movement can beachieved while maintaining stabilization of the lens 115 relative to theeye. In addition, movement and stabilization of the components of thegonio lens system 105 can be done without applying excessive force tothe eye.

In some embodiments of the gonio lens system 105, various components ofthe stabilization mechanism 120 can be immobilized relative to oneanother. For example, the position of the gonio lens 115 can be lockedin position relative to the handle 110. In this regard, one or moreactuators (not shown) may be included in the gonio lens system 105 whichcan be actuated, such as by a user, in order to lock and unlock one ormore components relative to each other.

The gonio lens system 105 can be disposable or re-usable and componentsand materials used in re-usable gonio lens system 105 can be effectivelycleaned, such as by autoclave. The handle 110 and stabilizationmechanism 120 can be made out of one or more of a variety of materialsincluding stainless steel, titanium, nitinol, plastics, or otherequivalent materials. In addition, the handle 110 can include one ormore malleable parts which can allow a clinician to customize the handle110, such as for improved ergonomics.

The gonio lens 115 can be manufactured out of one or more of a varietyof materials including optical glass, polymers, or other equivalentmaterials. In addition, the gonio lens 115 can be manufactured with oneor more coating, such as coatings that can at least one of minimizereflection, increase lens strength, or minimize damage to the lens. Inaddition, the gonio lens 115 can be substituted with a variety of otherocular lenses. Additionally, the gonio lens 115 can be substituted witha gonio mirror.

In some methods of use of the gonio lens system 105 an ocular lubricant(such as a viscoelastic substance) can be placed on the surface of thecornea prior to placement of any part of the gonio lens system 105against any part of the eye. Once the ocular lubricant has been applied,the gonio lens 115 can then be placed in contact with the cornea. Inaddition, the stabilization bracket 210 having one or more protrusions215 can be placed on the conjunctiva above the sclera. The clinician canthen use hand and wrist movements to manipulate the components of thegonio lens system 105. For example, the clinician can use the handle 110to control the stabilization bracket 210, including the protrusions 215,to assist in either moving the eye or holding the eye in a desiredposition. In addition, the clinician can use auxiliary tools, includingthe clinician's hand, to move or lock one or more components of thegonio lens system 105. Additionally, the clinician can use an auxiliarytool or the clinician's hand to move the gonio lens 115 relative to thelens bracket 225 and handle 110 while securing the eye in position withthe stabilization bracket 210.

FIGS. 7-9 illustrate another embodiment of a gonio lens system 500. Thegonio lens system 500 can include a handle 505 and a distal head region512 positioned on a distal end of the handle 505. The distal head region512 can include a gonio lens 502 which can assist a user in viewingvarious parts of the eye. In addition, the distal head region 512 caninclude one or more positioning features which can assist in moving andstabilizing a position of the eye.

FIGS. 8 and 9 show enlarged views of the distal head region 512, whichcan include an inner yoke 510 and an outer yoke 515. The gonio lens 502can be pivotally mounted to the inner yoke 510 via a pair of pins 526extending from a lens belt 525. As shown in FIGS. 8 and 9, the lens belt525 can secure and extend around at least a part of the gonio lens 502.The inner yoke 510 can be pivotally mounted to either a part of thehandle 505 or the outer yoke 515 such that the inner yoke 510 can pivotrelative to the outer yoke 515 and handle 505.

The gonio lens system 500 can also include a cleat ring 520 having oneor more protrusions or cleats 522 which can assist in positioning theeye. The cleat ring 520 can be U-shaped and pivotally mounted to theouter yoke 515, such as via a pair of pins 528 extending from a part ofthe cleat ring 520. The outer yoke 515 can include one or more hard stopfeatures 530 which can assist in limiting the rotational motion of thecleat ring 520 relative to the outer yoke 515. In some implementations,the cleat ring 520 can be rigidly connected to the outer yoke 515 whichcan prevent movement of the cleat ring 520 relative to the handle 505while still allowing the gonio lens 502 to move freely relative to boththe handle 505 and cleat ring 520.

As shown in FIGS. 8 and 9, the outer yoke 515 can extend distally fromthe distal end of the handle 505. An axis 552 located adjacent thedistal end of the handle 505 can couple with, such as extend through, aslot 550 extending along a length of the inner yoke 510. The axis 552can assist in movably coupling the inner yoke 510 to both the handle 505and outer yoke 515. For example, coupling of the axis 552 to the slot550 can allow the inner yoke 510 to rotate and translate relative to atleast the outer yoke 515 and handle 505.

Features of the inner yoke 510 and handle 505 can provide hard stops forboth the rotation and translation motion of the inner yoke 510 relativeto the handle 505. The inner yoke 510 can include a hard stop 605 whichcan assist in limiting the rotation of the gonio lens 502. For example,the lens belt 525 can include a tab 570 which can abut or mate with thehard stop 605 and limit the rotation of the gonio lens 502 relative tothe inner yoke 510. The rotational and translational aspects of thevarious components allow the gonio lens system 500 to conform to theshape of the eye globe and minimize pressure applied on the eye.

Additional components can be incorporated into the gonio lens system 500in order to provide additional movement of either the gonio lens 502 orcleat ring 520. Alternatively, fewer components can be incorporated inthe gonio lens system 500, such as in order to restrict the availablemovements of either the gonio lens 502 or cleat ring 520. Theavailability of motions of either the gonio lens 502 or cleat ring 520can be based on a user's preference or the application for which thegonio lens system 500 is to be used for.

Various configurations of the gonio lens system have been contemplated,including gonio lens systems which do not include a handle 505. In thisconfiguration, the clinician can interact with and adjust the distalhead region 512 without the use of the handle 505. Alternatively or inaddition, the gonio lens system can include a handle adapter which canallow the gonio lens system to be used with or without a handle 505. Thehandle adapter can include one or more adaptable features, such asthreaded holes, for allowing the handle 505 to couple to the handleadapter. In addition, more than one adaptable feature can allow thehandle 505 to couple to the handle adapter in more than one way in orderto form more than one configuration of the gonio lens system.

For example, the handle adapter can include three adaptable features,such as threaded holes, in three different positions which can allow thehandle 505 to form three different configurations, such as differentangular configurations between the gonio lens 502 and handle 505. Thedifferent angular configurations of the gonio lens 502 relative to thehandle 505 can provide a variety of viewing angles and ease ofmanipulation of the gonio lens 502 depending on, for example, whetherthe user is left handed or right handed. In addition, the variousadaptable features can be useful for configuring the gonio lens systemto better accompany a variety of procedures.

In some implementations, the cleat ring 520 can include variousfeatures, including a variety of cleat patterns. The cleat ring 520 canalso have any number of configurations, including a configuration wherethe cleat ring 520 is comprised of more than one cleat arc 521, as shownin FIG. 11. In addition, the cleat ring 520 and cleat arcs 521 can varyin shape and diameter in order to accommodate varying corneal diameters.

In some implementations, the cleat ring 520 or cleat arcs 521 can haveone or more cut-out portions which can assist in preventing pressure orforce from being applied to specific locations of the eye. In addition,the cut-outs can prevent obstruction to specific locations of the eye.Therefore, cut-out portions can assist in the implantation of variousimplants or surgical techniques requiring either access or less pressureapplied to specific locations of the eye.

Alternatively or in addition, some implementations of the gonio lenssystem 500 can have one or more alternate fixation features, such asvacuum or suture anchoring features. For example, a stabilizationfeature, such as the cleat ring 520 or cleat arcs 521, can include aseries of vacuum inlets which can suck the globe firmly against thestabilization feature. By way of further example, a stabilizationfeature, such as the cleat ring 520 or cleat arcs 521, can include asuture anchoring feature which can suture a part of the eye to thestabilization feature. Any number of a variety of anchoring features canbe included in any gonio lens system 500 for either securing ormanipulating the eye without departing from the scope of thisdisclosure.

A variety of additional features can be either included or adaptable tothe gonio lens system 500. FIG. 10 illustrates an embodiment of thegonio lens system 500 including a scleral depressor 540 feature. Thescleral depressor 540 can be permanently or removeably coupled to a partof the gonio lens system 500, such as the handle 505. In addition, thescleral depressor 540 can include a finger adapter 542 for allowing auser's finger to control the scleral depressor 540. Alternatively or inaddition, some implementations of the finger adapter 542 can beconfigured to move the gonio lens 502, such as in the proximal or distaldirection relative to the handle 505. This can allow the user to easilycontrol the position of the gonio lens 502, such as raise or lower thegonio lens 502 onto the eye with the use of one or more fingers of thehand grasping the handle 505.

In some implementations, the scleral depressor 540 can be slidinglycoupled to the handle 505 such that a user can push or pull the fingeradapter 542 in order to cause the scleral depressor 540 to extenddistally or proximally, respectively, relative to the handle 505. Asshown in FIG. 10, a distal end 544 of the scleral depressor 540 canextend distally past the cleat ring 520 which can allow the scleraldepressor 540 to apply a force on the sclera while the cleat ring 520 ispositioned on the eye. The scleral depressor 540 can also be retractedso that the distal end 544 of the scleral depressor 540 does not extenddistally past the cleat ring 520. The distal end 544 of the scleraldepressor 540 can be sized and shaped (e.g., a rounded configuration) inorder to prevent damage upon contact and applying a force to the eye.

The scleral depressor 540 can be used to bring eye tissues andstructures (e.g., the iridocorneal angle) into a field of view, such asthrough the gonio lens 502. For example, improved visualization of theangle can be achieved with a force applied on the eye by the scleraldepressor 540 causing the angle structures to be brought more forwardand into the anterior chamber. Therefore, the scleral depressor 540 canimprove visualization by bringing the angle structures more forward intothe anterior chamber and thereby reducing the required depth ofvisualization. The scleral depressor 540 can also be useful foraccessing and visualizing Schlemm's canal, such as for implanting anocular implant in the suprachoroidal/supraciliary space, or anyequivalent or related action.

In some methods of use of the gonio lens system 500 an ocular lubricant(such as a viscoelastic substance) can be placed on the surface of thecornea prior to placement of any part of the gonio lens system 500against any part of the eye. Once the ocular lubricant has been applied,the gonio lens 502 can then be placed in contact with the cornea. Inaddition, the cleat ring 520 or cleat arcs 521 having one or moreprotrusions 522 can be placed on the eye, such as on the conjunctivaabove the sclera. The clinician can use hand and wrist movements tomanipulate the components of the gonio lens system 500. For example, theclinician can use the handle 505 to control the cleat ring 520 or cleatarcs 521, including the protrusions 522, to assist in either moving theeye or stabilizing the eye in a desired position. As mentioned above,fixing or stabilizing the eye in a desired position can be beneficial insome procedures, such as during implantation of an ocular implant. Inaddition, the clinician can use auxiliary tools, including theclinician's hand, to move or lock one or more components of the goniolens system 500. Additionally, the clinician can use an auxiliary toolor the clinician's hand to move the gonio lens 502 relative to thehandle 505 while securing the eye in position with the cleat ring 520 orcleat arcs 521.

In some methods of use of the gonio lens system 500, the clinician canengage the finger adapter 542 of the scleral depressor 540 in order tocause the scleral depressor 540 to extend distally or proximallyrelative to the handle 505. For example, the clinician can push thefinger adapter 542 in order to distally extend the scleral depressor 540and cause the distal end 544 to apply a force onto the eye, such as onthe sclera. This can allow the clinician to improve visualization oftissues and structures of the eye, including the angle of the eye. Whilethis specification contains many specifics, these should not beconstrued as limitations on the scope of an invention that is claimed orof what may be claimed, but rather as descriptions of features specificto particular embodiments. Certain features that are described in thisspecification in the context of separate embodiments can also beimplemented in combination in a single embodiment. Conversely, variousfeatures that are described in the context of a single embodiment canalso be implemented in multiple embodiments separately or in anysuitable sub-combination. Moreover, although features may be describedabove as acting in certain combinations and even initially claimed assuch, one or more features from a claimed combination can in some casesbe excised from the combination, and the claimed combination may bedirected to a sub-combination or a variation of a sub-combination.Similarly, while operations are depicted in the drawings in a particularorder, this should not be understood as requiring that such operationsbe performed in the particular order shown or in sequential order, orthat all illustrated operations be performed, to achieve desirableresults. Only a few examples and implementations are disclosed.Variations, modifications and enhancements to the described examples andimplementations and other implementations may be made based on what isdisclosed.

1. A gonio lens system, comprising: a handle including a stabilizationbracket having one or more protrusions for positioning on the eye; agonio lens; and a stabilization mechanism that movably attaches thegonio lens to the handle, wherein the stabilization mechanism is movablerelative to the handle and wherein the stabilizing mechanism couples tothe bracket of the handle so as to allow the bracket to move relative tothe handle and stabilize the protrusions relative to the eye. 2-4.(canceled)
 5. The system in claim 1, wherein the protrusions include atleast one of a rounded shape and a surface feature for controllingmovement of the eye.
 6. The system in claim 1, wherein the stabilizationmechanism includes a lens belt secured to at least a part of the goniolens, with the lens belt including a pair of extruding pins coupled to apair of slots extending along a part of a lens bracket.
 7. The system inclaim 6, wherein the lens bracket is pivotally mounted to a support of astabilization bracket, with the stabilization bracket pivotally mountedto a bracket extending from a distal end of the handle.
 8. The system inclaim 7, wherein at least one of the lens bracket, stabilization bracketand stabilizing bracket is U-shaped.
 9. The system in claim 6, whereinthe lens bracket includes a tab which mates with a biasing membersecured to a part of the stabilization mechanism in order to limitrotational movement of the lens bracket and bias the gonio lens towardsthe eye.
 10. The system in claim 1, wherein at least one of the handleor stabilization mechanism is made out of one or more materials,including stainless steel, titanium, nitinol, plastics, or otherequivalent materials.
 11. The system in claim 1, wherein the gonio lensis manufactured out of one or more materials including optical glass,polymers, or other equivalent materials.
 12. The system in claim 1,wherein the gonio lens is coated with one or more coatings, includingcoatings which at least one of minimize reflection, increase lensstrength, and minimize damage to the lens. 13-20. (canceled)